Hey Percy, could you please give us your expertise? (Page 2 of 2)

This is a reprint message about ASCO's point of view about biomarkers at 2011.

Below is the ASCO message about biomarkers usage.

What to Know: ASCO's Guideline on Tests to Help Choose Chemotherapy

Introduction

To help doctors give their patients the best possible care, the American Society of Clinical Oncology (ASCO) developed evidence-based recommendations on the usefulness of laboratory tests (called assays) to find out if a cancer might be resistant or sensitive to a specific chemotherapy treatment before it is offered to a patient. In 2011, this guideline was reviewed due to new research; this research continued to support the 2004 recommendations. This guide for patients is based on ASCO’s most recent recommendations.

Key Messages

    Chemotherapy sensitivity and resistance assays are laboratory tests that have been studied to help predict how well chemotherapy may work.

    However, these tests should not be used to determine treatment options for an individual patient.

    Instead, the choice of chemotherapy should be based on the research on the drugs being considered and the patient’s health and treatment preferences.

For additional info, go to cancer.net,home,publishing and resources,what to know ASCO guidelines
God bless.

Hi,Pamela,
First ,here are some guidelines or principles  from a chapter of the textbook of "Oncologic Disorders" title  "Cancer chemotherapy and Treatment."

"The underlying principles of using combination chemotherapy are to use
1. agents with different pharmacologic actions,
2. drugs with different organ toxicities,
3.agents that are active against the tumor and ideally synergistic when use together,
4.agents that do not result in significant drug interactions."

Even though the combination of 5 FU and Gemzar is not as strong as the Gemzar/Cis combo and at most may be in the same effectiveness as Gemzar alone as indicated by a couple studies.However, base on my research,the toxicities of the drugs in the platinum family like cisplatin will pop up around the 6 cycle time frame as the drug accumulated over the course of treatment;that include allergic reaction to the drug and other side effects like nephrotoxicity(decrease kidney function) and neuropathy( hand-and-foot symptoms) and low blood cells count(WBC,platelets and RBC). ;therefore as a whole, I think your oncologist's decision is prudent if she decided to eliminate the cisplatin .She is thinking ahead of how to treat your daughter before side effects pop up. this is especially true if the CAT scan or MRI will show STABLE response or tumor shrinkage on March 8.. You can always add the cisplatin back  if needed.

So base on what the principles of the text book and the toxicity of the platinum;and the sign of a prudent oncologist that knows what to do .
I will not recommend any change of the suggestion that provided by your oncologist.Also in doing so, you will reserve more options down the road if needed.
good luck in surgery.
God bless.